Medicare and Working Past 65

Many people keep working after 65. Whether you should sign up for Medicare right away depends on your employer's size and your coverage.

Employer size matters

• 20 or more employees: your group health plan generally pays first, and Medicare pays second. Many people delay Part B without a penalty.
• Fewer than 20 employees: Medicare generally pays first. You usually need Part A and Part B, or your employer plan may not pay for much.

Part A while working

Part A is premium-free for most people, so many workers sign up for Part A at 65. The exception: if you contribute to a Health Savings Account (HSA), you cannot contribute once you have any part of Medicare. See Medicare and HSAs.

Signing up when you stop working

When your job or the coverage ends, whichever happens first, you have an 8-month Special Enrollment Period to sign up for Part B without a penalty. You will need your employer to complete a form confirming your coverage. You generally have 2 months after your employer coverage ends to join a Medicare Advantage or Part D plan.

Drug coverage

Ask your employer for its creditable coverage notice. If your drug coverage is creditable, you can delay Part D without a penalty. See the Part D late enrollment penalty.

Higher income?

If your income is above $109,000 (individual) or $218,000 (joint), you will pay more for Part B and Part D. See IRMAA 2026. If your income drops because you retire, you can ask Social Security to use your new income.

Frequently asked questions

Do I need Medicare Part B if I am still working at 65?

If your employer has 20 or more employees and you have coverage through current work, you can usually delay Part B without a penalty. With a smaller employer, Medicare usually pays first, so you generally need Part B.

How long do I have to sign up for Part B after I retire?

You have 8 months after your job or employer coverage ends, whichever comes first, to sign up without a penalty.

Should I sign up for Part A while I am working?

Most people can, because Part A is usually premium-free. If you contribute to an HSA, signing up for Part A ends your ability to contribute.

Is my employer drug coverage good enough to delay Part D?

Only if it is creditable. Your employer must tell you each year whether its drug coverage is creditable.

Talk with a licensed agent

Questions about your Medicare options? Call 1-844-438-6284 (TTY 711) or request a free, no-obligation quote. We do not offer every plan available in your area.

Sources for 2026 figures: CMS 2026 Medicare Parts A & B Premiums and Deductibles; Medicare.gov: Medicare costs; Medicare.gov: Part D costs. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).